Category Archive: Policy

Primary care today: There are several concerning trends

In 2006 Dr. Tom Bodenheimer wrote an article that was published in the New England Journal of Medicine entitled, “Primary Care – Will It Survive?” Dr. Bodenheimer spoke with great concern about patients’ growing unhappiness with their primary care phys…

Redefining quality through a patient-centered approach

Ask any physician what quality is, and you’ll get many different answers. You will hear answers such as “finding a cause for their pain,” “ruling out a life-threatening condition,” “partnering with patients to improve their health” or “offering the mos…

The Wild West approach to PICU practice

I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’…

The blood of patients is not a rhetorical device

Recently, social media and news organizations have been awash in the physician-led backlash to the NRA’s now infamous “stay in your lane” tweet, and consequently, awash in images of the literal blood of seriously wounded or now deceased patients. Gun c…

6 ways to smooth the journey to value-based care

I have had the fortune — both good and bad — of being at the forefront of reforming physician reimbursement as an advocate for physicians. I’ve worked on models spanning private practice, group employment, faculty practice plans, and independent physic…

This isn’t just my lane, it’s my highway

On Wednesday, I did a gunshot-wound autopsy. On Friday, I was going into the morgue to perform another when I checked Twitter and saw this. Doctors across the U.S. and across medical specialties were already responding and sharing photos: their face sh…

Money will be lost in health care. This is true no matter how we describe it.

Does anyone in medicine, particularly emergency medicine, understand why we lose money? Why we have to push those metrics so hard to capture every dime? I mean, we’re constantly reminded that satisfaction scores, and time-stamps and time to door, time …

Here’s what the corporatization of medicine is doing

Have you ever been to a doctor’s office and felt that your evaluation was rushed? Have you been seen in the emergency room and felt that you were just a number in a long series of patients? Have you ever seen the same doctor for years and felt like the…

Health care is on a different trajectory from most other businesses. Why is that?

Health care is on a different trajectory from most other businesses today. It’s a little hard to understand why. In business, mass market products and services have always competed on price or perceived quality. Think Walmart or Mercedes-Benz, even the…

The problem with mental health funding and prisons

Moving to the Bay Area from the Midwest was a culture shock in many ways. I was amazed by the diversity, the food, the openness of opinions. And I was struck by the traffic, the stark differences driving from one community to another and the homelessne…

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